Who's Really Putting Patients First?

Pharma companies are increasingly recognizing the value of patient-support programs and the resources they provide that help patients manage their conditions in a more holistic and supportive way. This is particularly true with chronic diseases, where adherence and persistence remain significant problems. But how well are these patient-support programs performing?

An expansive study of current patient-support programs uncovered some surprising results, including the following:

• Out of 59 leading brands for chronic conditions, more than half don't even offer a patient-support program

• While few programs perform consistently well against all measurement criteria, several set “best practice” standards in specific areas

• All patient-support programs have substantial opportunities for improvement against best practices

The power of six: How the programs were rated

To evaluate the effectiveness of each patient-support program, MicroMass developed a set of six evaluation criteria based on an exhaustive review of secondary literature and third-party studies and guidelines. The study drew on behavioral science to predict the drivers of positive health outcomes, also looking to other industries to appreciate what drives consumer loyalty and perceptions.

The six evaluation categories are:

1. Health education principles

2. Treatment attitudes

3. Illness perceptions

4. Patient-healthcare provider relationships

5. Social/environmental factors

6. Marketing integration

For each of these categories, specific evaluation questions were developed and assigned a numeric value, permitting each program to be reviewed against responses to the questions on a 100-point scale.

The study next identified 13 chronic diseases and the 59 brands commonly used to treat them. Since many brands did not offer patient-support programs, the study ended up with 25 programs to evaluate.

Researchers registered for each program using two distinct patient profiles and systematically logged all materials received. To be as inclusive as possible, “patient-support programs” were defined as any support services associated with a brand that patients could register for online or via regular mail. Professional marketing materials associated with these brands were also examined, but behaviorists did not have access to patient resources developed for use and distribution through healthcare provider offices. For objectivity, programs developed by MicroMass were excluded.

Who's leading the way?

Those who create patient-support programs know the many challenges faced in bringing them to market. Behind the end product are many months of research, planning, conception, content development, design, medical-legal-regulatory reviews, production, programming and testing. Following this arduous process, the final program is rarely what was originally envisioned.

Despite these challenges, many brands are delivering thoughtful and valuable patient-support programs. The top six overall were Enbrel (Amgen/Pfizer), Betaseron (Bayer), Gleevec (Novartis), Januvia (Merck), Victoza (Novo Nordisk), and Rebif (EMD Serono). And while no one brand is delivering equally well across all six evaluation categories, some are doing especially well in individual categories. Here are three patient-support programs that stand out in this way:

Humalog “Small Steps” Eli Lilly & Co.

The health education principles dimension of the evaluation framework is about employing best-in-class approaches that ensure messages are understood by, relevant to, and engaging for patients. Examples of specific criteria within this dimension include developing content at appropriate health-literacy levels, application of learning styles, and delivery of targeted information. Humalog's Small Steps program received one of the highest scores in this dimension at 83%.

The materials within Small Steps use icons, photos and simple illustrations to reinforce important concepts like symptoms of low blood sugar and mealtime blood-sugar spikes. There is also an interactive “scratch-off” checklist in one of the direct-mail pieces that helps simplify key steps and encourages patients to establish positive patterns surrounding their mealtimes.

Rebif “MS LifeLines” EMD Serono

The social/environmental factors part of the framework involves reducing functional barriers (e.g., cost), increasing environmental support, and integrating treatment into patients' everyday lives. The Rebif “MS LifeLines program got a score of 86% in this category.

The program provides support directly to patients to help reduce cost and insurance barriers. But it goes the extra mile by surrounding patients with a virtual support team of reimbursement counselors, nurses and customer support specialists. Patients can call the MS LifeLines call center at any hour and speak to a live representative.

The program also offers patient-to-patient support, giving patients the option of being connected with a Patient Ambassador so that they can hear another patient's perspective on their condition.

Enbrel Support Amgen/Pfizer

The marketing integration dimension of the evaluation framework involves capitalizing on core principles to differentiate brands and deliver a satisfying customer experience. Criteria include program integration with brand identity, customer service, and follow-through. The Enbrel Support program rated highly (89%) in this category.

This program is clearly integrated into the Enbrel brand story as evidenced by the brand tagline: “Proven results. Ongoing support.” Even in the healthcare professional marketing messages, the patient-support offering is positioned as a key product attribute, and given nearly equal prominence as clinical messages. It also offers a superior customer experience. Its first direct-mail package to patients clearly explains how many mailings patients will receive and what topics are covered—a touch that tells patients that the program is committed to delivering the experience it has developed for them.

Where do we go from here?

All brands should look closely at patient support, but chronic disease brands have a greater need to invest now. For many conditions, such as diabetes and hypertension, medication compliance and lifestyle changes are crucial to disease management—to the point that evidence-based guidelines call for an equal emphasis on prescription treatment and lifestyle behaviors such as diet and exercise.

Patient-support programs can play a key role in improving health outcomes, but to be successful, they need to consider and evaluate themselves against the six criteria identified. There are legitimate reasons to choose a less-than-holistic approach to building patient-support programs—restricted marketing budgets, predominantly prescriber-driven frameworks, and treated conditions that place less of a burden on patients to self-manage. But regardless of the variables, an opportunity remains for companies to improve health outcomes and drive brand value with effective patient-support offerings.

For a full report on this analysis, visit www.micromass.com/patientsupport.

Alyson Connor is partner and senior vice president of strategic and behavioral services, MicroMass Communications

Keys to developing patient-support initiatives:

Be truly patient-centric. Address the behavioral levers that have been proven to help patients succeed.

Deliver relevant messages. Of programs surveyed, 72% asked behavioral questions during enrollment, but few delivered messaging relevant to the responses.

Integrate patient-support offerings into your brand story. In your professional marketing materials, use your patient-support program to redefine “value” to the prescriber beyond efficacy and safety.

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